The functional medicine approach is great for treating migraine in its roots. To achieve this goal, it uses the Functional Medicine operating system. This includes the systems biology approach known as the Functional Medicine Matrix, therapeutic lifestyle factors such as sleep, movement & exercise, nutrition, relationships, relaxation, and stress.

What is migraine?

Do excruciating and debilitating headaches intervene with your ability to accomplish anything? Most of the headaches that occur occasionally can be treated effectively by resting, eating or taking over-the-counter painkiller medication. But some headaches like migraines are the most common neurological condition that can make it hard just to get through the day. Migraine is a neurological condition typically characterized by recurrent headaches that are moderate to severe. The prevalence of migraine is quite high and it is found to be the third most common disease in the world apart from diabetes, epilepsy, and asthma with an estimated global prevalence of around 15%.

Warning symptoms known as “aura” may occur before or with the headache. These can include flashes of light, blind spots, or tingling on one side of the face or in your arm or leg. Migraine can mimic the symptoms of stroke, and leave a stroke in its wake, or be associated with a seizure. More complex presentations of migraine may not have headache as a prominent symptom. Vertigo (a false sense of motion), slurred speech, ringing in the ears, double vision, staggering gait, and loss of consciousness can be associated with migraine with brainstem aura.

A migraine can cause severe, often throbbing pain usually on just one side of the head. It is often accompanied by nausea, vomiting, sensitivity to light and sound, and worsening of symptoms with activity. Although a single episode of migraine lasts 4 to 72 hours those with Chronic Migraine experience a minimum of 8 migraine days per month and at least 15 days per month of headache of any kind.

Migraine can finally be put to a stop by numerous breakthrough treatments available today. Some of them include ergot alkaloids and triptans. However, these interventions tend to have a number of side effects including nausea and vomiting, feelings of tingling, flushing, dizziness, weakness, drowsiness, tiredness, gangrene and myocardial infarction. Some other disadvantages of these treatments involve their high cost and the restrictions on their use in the presence of cardiovascular diseases.

Functional medicine is such an effective holistic therapy that has a different approach altogether. Most migraine patients who do not respond to conventional medical treatments, also seek alternative therapy that brings relief to them. Therapies like functional medicine, Acupuncture, Ayurveda, botulinum toxin, and mind-body interventions options are the most popular treatments.

What triggers migraines?

What are the triggering factors that give rise to Migraine?

Migraine triggers can be unique to each person, and it is often associated with many other factors. A migraine attack basically involves abnormal brain activity that can be triggered by many things and the best way to avoid a migraine attack is to avoid what starts them in the first place. Various causes that can lead to migraine involve:

Hormonal changes: Migraine is more prevalent in women when compared to men. A woman experiences hormonal changes during menstruation that can cause migraine attacks. This is also termed as a menstrual migraine during which the levels of both the female hormones like estrogen and progesterone fall down.

Emotional triggers: It is one of the most common migraine triggers where conditions like depression, stress, anxiety, shock, and excitement can trigger a migraine headache by releasing chemicals in your brain that cause a “fight or flight” response.

Melatonin imbalance – Melatonin is known to possess a chronobiotic (biological clock), antioxidant, antihypertensive, anxiolytic, analgesic and a sedative effect. The melatonin levels are found to be low in migraine suffering individuals

Triggers in the diet: It has been known that certain food that contains tyramine can contribute to migraines which may include chocolate, cheese, citrus fruits, alcohol, and caffeine. Skipping your meals, Irregular mealtimes, low blood sugar, magnesium deficiency, vitamin B deficiency, dehydration and jet lag can also act as potential triggers in causing a migraine attack.

Sensory overload.: Some factors that can increase the load on your sensory organs and trigger migraine may include flickering screens, Bright lights, loud sounds, Stuffy rooms, and strong smells that can set off a migraine in some people.

Medications: A medication that alters hormonal changes like hormone replacement therapy (medications), contraceptive pills sleeping pills, is also found to be the possible triggers.

A combination of genetics and environmental factors appear to play a role in migraine. Migraine may be caused by changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway. Imbalances in brain chemicals – including serotonin, which helps regulate pain in your nervous system – also may be involved. Serotonin levels drop during migraine attacks. This may cause your trigeminal nerve to release substances called neuropeptides, which travel to your brain’s outer covering. The result is migraine pain. Other neurotransmitters play a role in the pain of migraines, including calcitonin gene-related peptide.

How does Functional Medicine view Migraines?

The root cause of your migraine might not be in your head at all. In fact, it might be brought on by many other factors. Since functional medicine evaluates the causes of chronic illness the functional medicine approach is ideal for addressing migraine at its roots. To accomplish this goal, it uses the Functional Medicine operating system. This consists of the Functional Medicine Timeline, The Functional Medicine Matrix, and the Therapeutic Lifestyle Factors (Sleep & Relaxation, Movement & Exercise, Nutrition, Stress, and Relationships). Functional Medicine Matrix, based on a scientific framework known as “systems biology,” allows the practitioner to evaluate imbalances at the cellular level. This helps sort out why the disease has occurred in the first place. By understanding each of these imbalances the person with migraine is empowered to make changes to correct them. Each part of the Matrix is called a “node,” and there are seven nodes on the Functional Medicine Matrix. [1]

These are defined as part of the Functional medicine toolkit to better get to the root cause of the ailment in the following biological systems, called nodes: defense and repair, energy, biotransformation and elimination, transport, communication, structural integrity, and assimilation.

Other effective approaches (like functional medicine) for migraine are available that can help alleviate not just the symptoms caused by a migraine but also treat the underlying cause behind the disease. Some of them include

- Balancing your hormones: One of the best ways to balance your hormones is to exercise and perform yoga and pranayama on a daily basis. Maintain your sleep cycle by sleeping on time and waking up early.

- Probiotics- Can have positive effects on strengthening gut and brain function by decreasing the inflammatory mediators in the bloodstream. Inflammatory mediators like cytokines and tumor necrosis factor are known to be predominant in migraine patients. Probiotics like cephalalgia are one of the best probiotic for migraine that has shown a beneficial effect on reducing the frequency, duration, and severity of migraine headache attacks.

- Nutraceuticals- A variety of natural supplements, that consists of taking vitamins, supplements like riboflavin, coenzyme Q10, magnesium, and alpha-lipoic acid and herbal preparations which include feverfew and butterbur, has offered an alternative source of therapy for migraine sufferers and its usage have been promoted as having efficacy in migraine prophylaxis

- Diet therapy- Eliminating certain food allergens that are IgG based can help improve and treat migraine sufferings. Also, consuming foods that are gluten-free and rich in magnesium, and vitamin B can provide relief from migraines.

Research in Functional Medicine for Migraine

Recent studies have shown that patients with gastrointestinal disorders are at higher risk of being associated with migraine. A literature review ‘Potential Beneficial Effects of Probiotics on Human Migraine Headache: A Literature Review’ published in Pain physician, has explained a potential link between migraine and gastrointestinal disorders. The review suggests that increased intestinal epithelial permeability may lead to inflammation that is found to be associated with migraine headache pathophysiology. The intestinal microbiota has been found to directly alter neurotransmitter levels, in the brain indicating the possibility of established communication between bacteria and neurons. Patients with migraine headaches have been investigated with elevated plasma levels of proinflammatory cytokines, and tumor necrosis factor-α, which may be due to undigested food particles and bacterial metabolites. These undigested metabolites like bacterial endotoxins, lipopolysaccharides, can enter the bloodstream as a result of increased intestinal permeability and may act on the trigeminovascular system to consequently trigger migraine-like attacks.

The review also inferred that probiotics may have a beneficial effect on the frequency and severity of migraine headache attacks as they improve gut microbiota and help eliminate inflammation.

A clinical trial conducted on a total of 21 patients with migraine has reported that eliminating the immunoglobulin G (IgG)-based diet can be an effective and inexpensive therapeutic strategy in migraine patients concomitant with gastrointestinal disorders like irritable bowel syndrome (IBS). Immunoglobulin (IgG) antibodies have been reported to be associated with migraine against various food antigens. The study was designed as a double-blind, randomized, controlled, clinical trial that composed of 3 phases, including baseline phase (usual diet), first diet phase (elimination or provocation diets, customized based on sensitivity results), and second diet that included interchange of elimination and provocation diets phase. The patients were asked to make 4 evaluation visits.

Frequency, duration, severity and headache attacks were significantly reduced after eliminating IgG-reactive food for a specific period showing improved quality of life in the patients.

Summary

Complementary therapy approaches like functional medicine for migraines are emerging trends in the treatment for migraines because they address the root cause of the ailment. Along with yoga, oil therapy, exercise, and dietary changes one can not only effectively reduce various symptoms that arise from migraines, but also realize potential savings to the health care system with fewer side effects. Research has shown that people who receive preventive medications like regular exercise, avoiding fasting and healthy meals, relaxation/biofeedback, elimination of medication overuse, tend to recover earlier and faster when compared to the ones who are just taking conventional therapies.

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